Weekly Motivation

When You Want to Succeed as Bad as You Want to Breathe, Then You'll Be Successful. (11)

Nothing like the power of thought. Everything you put your mind to literally turns into real life. If your thoughts are constantly positive and you think about your goals daily then they eventually become real and tangible. I’ve seen this so many times with not only my life but in the lives of others. Stay positive this week and keep your thoughts on the prize!


Weekly Motivation

When You Want to Succeed as Bad as You Want to Breathe, Then You'll Be Successful. (10)

Life is a journey people. Don’t worry about what everyone else around you is doing. This is your race. Don’t worry where you’re at – small, consistent steps towards your goals is better than not progressing at all. I see patients that want to get better after one visit. Unfortunately this isn’t how it works 99% of the time. It takes a dedicated/proactive  effort to get better – not just physically, but in all aspects of life. Just like our goals and things we want to accomplish, it usually doesn’t happen overnight.

Weekly Motivation

When You Want to Succeed as Bad as You Want to Breathe, Then You'll Be Successful. (8)

Sometimes in our pursuit of our goals, we experience tunnel vision. We only see the end and nothing else. These goals are things that we want and that’s OK. Be focused. Show relentless pursuit of your goals.

But remember the things and people around you that you have RIGHT NOW. Don’t let that pursuit of your goal cause you to neglect what’s important at the current moment.


Weekly Motivation

When You Want to Succeed as Bad as You Want to Breathe, Then You'll Be Successful. (7)

So what makes success that much better once you achieve it?

Your struggle.

Your struggle, the low points, the grind, and the times where you feel like things aren’t going your way are the moments that truly define you.

I remember my grind – being a new dad, a husband to be, being in PT school, finishing my clinical rotations, working, all while trying to manage assignments, projects, as well as trying to manage friendships. These are all blessings, but it was one of the hardest times of my life because I had a ton of responsibility and wasn’t sure how I was going to manage ALL of it.

That part of my life was a GRIND. But, I got through it – and I learned so much from it. My support system from my family, friends, coworkers, etc. was amazing and would not have gotten through it without them.

Keep grinding people because it only gets better. Your struggle is what makes your success all the more sweeter.

Athletic Focus: Collarbone Fractures


This week’s focus is on COLLARBONE FRACTURES. It’s a big topic right now as one of the NFL’s premier quarterbacks, Aaron Rodgers, suffered this injury this past weekend. Unfortunately for Packers fans, it’s not looking good as it seems he’s going to be put onto the Injured Reserve. With an injury like this, considering it is his throwing arm, it might take a while for him to fully recover.


What is it?

Your collarbone is just another term for your clavicle. Medially, it attaches to the center of your chest (sternum) and attaches laterally at the scapula through the acromioclavicular ligament and the coracoclavicular ligaments. The collarbone plays a huge role in protecting soft tissue, nerves, and arteries that run in the front of your chest and also assists in upward movement of the shoulder.



How do you break your collarbone?

The two most common ways for the collarbone to break is through a direct blow to the shoulder (i.e. direct hit) or by falling directly onto the shoulder.

clavicle impact

aaron rodgers

Is it broken?

It’s fairly easy to tell if you do break your clavicle as their will be a palpable bump near your shoulder. Other signs will include severe pain, inability to flex (raise) the arm, immediate swelling, as well as a grinding type sensation when trying to lift the arm. The most definitive way to tell is with an X-ray, however, it’s pretty obvious when you see one!

Do you need surgery?

In some cases, yes, surgery is indicated. If the fracture is bad (i.e. there’s fragments, severe break) then surgery is performed with an internal fixation (screws and bolts) to hold the bones together to promote healing.

Conservative Treatment

If surgery is not indicated, then conservative treatment will usually include physical therapy to facilitate the healing process. After a fracture, patients will wear a sling to support the arm and to place it in a position that promotes normal healing of the broken bone.

Initial physical therapy includes gentle range of motion exercises to restore normal movement as well as pain reducing interventions (i.e. – manual therapy, heat/ice, electrical stimulation).

As you begin to restore range of motion, strengthening exercises can be introduced to restore normal mechanics and strength of the shoulder and upper arm muscles.


Full return to sports or activities can take up to between 3-5 months depending on the severity of the fracture as well as if proper facilitation of healing took place.


So there’s the basic explanation of the injury. It’s always sad to see great players have season-ending injuries, but it is  part of the game. Unfortunately, Aaron Rodgers caught a bad break and now his season looks to be in jeopardy.


Dr. Jomar Farrales, PT, DPT


Weekly Motivation

When You Want to Succeed as Bad as You Want to Breathe, Then You'll Be Successful. (6)

Here’s your weekly motivation! I remember first getting into physical therapy school and thinking to myself, “How am I ever going to learn ALL of this information?” It was overwhelming.

To be honest it was like learning a new language. Fast forward 7 years later and now I can say with pretty good confidence that I do consider myself an “expert” in what I do.

Remember that it takes time to build your craft. Don’t feel discouraged if you’re not where you’re at right now. Keep working towards that goal.


The Opioid Crisis – How PT Can Help

Within the United States, opioid use and opioid-related deaths have reached a staggering rate.

According to the US Health and Human Services, in 2015 alone, 33,091 people died from opioid use and over 12.5 million people misused opioids that were prescribed by their physicians. Furthermore the CDC states that 91 people die everyday from opioid overdose. The numbers are staggering and they continue to climb. The following graphic shows many of the recent numbers regarding opioid epidemics.


Factsheet on Opioids


What is an opioid?

According to the National Institute on Drug Abuse opioids are, “a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others.”


The numbers are even worse close to home. In Rhode Island alone, over 1000 people died within the last 5 years, which tops all New England states.

Why the Epidemic?

I don’t like to make generalizations as everyone’s individual case is different. So I will share reasons that I have personally encountered in my personal and professional life that I feel contribute to the epidemic.

  1. People have no other options. When it comes to pain, sometimes it can get so severe that when physicians no longer prescribe opioids, many turn to illicit drugs like heroin or fentanyl – much cheaper options. This then can begin a deadly cycle of addiction.
  2. People don’t know their other options. I’ve talked to many people and when they explain their situation to me, many do not realize that physical therapy was even an option to begin with in helping them with their pain, or their experience with their physical therapist did not go so well.
  3. Cost of Physical Therapy. Cost of physical therapy for some people is another reason why many are stuck with taking opioids for their pain. High deductible rates can place a financial burden on individuals. So when people cannot afford it, they visit their physician asking for more opioids.
  4. Insurances Will Not Give More Visits. Some insurance companies limit the number of visits one can have, which is understandable in some cases, however, some make it extremely difficult to approve for more visits. In the end the patient is still in pain.


How PT can Help

  1. Physical therapists are educators. As a PT, I believe our first job is to educate the public. It’s really important to let patients know the side-effects of opioids, what it can lead to, and what our role is in their health.
  2. PT solves the ACTUAL cause of pain, whereas opioids mask it. While pain reduction is important, pain also gives a signal to our brain that something isn’t right. So when someone on opioids doesn’t feel their pain they may do more damage to themselves. PT will address the real issue of the cause to one’s pain rather than masking it.
  3. Non-pharmacologic interventions are the preferred option when managing chronic/acute pain.
  4. Movement and exercise are natural pain killers. PT’s can help you move in a non-threatening way. Exercise has also been shown to improve pain by releasing natural endorphins within the body.


Please consult or seek out a physical therapist if you or anyone you know is dealing with pain. Possible addiction is not worth it!


Dr. Jomar Farrales, PT, DPT